Organization
BONITA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD SAMER ELHOMSY PHARM.D (CEO/OWNER)
(619) 952-9009
Entity
Organization
Contact information
Practice address
4190 BONITA RD STE 101, BONITA, CA 91902-1330
(619) 952-9009
Mailing address
4190 BONITA RD STE 101, BONITA, CA 91902-1330
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
PHY 51970
CA
3336C0003X
Community/Retail Pharmacy
PHY 51970
CA
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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